Gastrointestinal symptoms are common in soldiers in combat or high-pressure operational situations and often lead to compromised performance.
Underlying mechanisms are unclear, but neuroendocrine dysregulation, immune activation and increased intestinal permeability may be involved in stress-related Gastrointestinal dysfunction.
Dr Li and colleagues evaluated the effects of prolonged, intense, mixed psychological and physical stress on intestinal permeability, systemic inflammatory and stress markers in soldiers during high-intensity combat-training.
In 37 male army medical rapid response troops, gastrointestinal symptoms, stress markers, segmental intestinal permeability using the 4-sugar test and immune activation were assessed during the 4th week of an intense combat-training and a rest period.
The researchers noted that a combat-training elicited higher stress, anxiety and depression scores as well as greater incidence and severity of gastrointestinal symptoms compared with rest.
|Segmental gastrointestinal permeability increased during combat-training compared with rest|
|Alimentary Pharmacology & Therapeutics|
The IBS-SSS correlated with depression and stress ratings.
The team of doctors found that the serum levels of cortisol, interleukin-6, and tumor necrosis factor-α, and segmental gastrointestinal permeability increased during combat-training compared with rest.
The lactulose:mannitol ratio was higher in soldiers with gastrointestinal symptoms during combat-training than those without.
Dr Li's team concludes, "Prolonged combat-training not only induces the expected increases in stress, anxiety and depression, but also gastrointestinal symptoms, pro-inflammatory immune activation and increased intestinal permeability."
"Identification of subgroups of individuals at high-risk of gastrointestinal compromise, and of long-term deleterious effects of operational stress as well as the development of protective measures will be the focus of future studies."